First-lineVentolin
Salbutamol
Short-acting β2-agonist (SABA)
Rescue bronchodilator — safe in every trimester.
Inhaled (MDI/nebuliser)IV (severe)
First-line for
- Acute asthma in pregnancy
- Chronic asthma reliever
Mechanism
β2-agonism → cAMP ↑ → bronchial smooth muscle relaxation and mast cell stabilisation.
"Ventolin ventilates the mother, oxygenates the baby"
- Uncontrolled asthma is far more dangerous than any inhaler
- MgSO₄ IV if severe/life-threatening
- Beware nebs → tremor, tachycardia, hypokalaemia
Dosing
- Reliever MDI
- 100–200 μg PRN (via spacer)
- Acute severe (neb)
- 5 mg back-to-back, then hourly
- IV (life-threatening)
- 250 μg slow IV → 5 μg/min infusion
Contraindications
- CautionSevere cardiovascular disease
Side effects
- Tremor, tachycardia
- Hypokalaemia (severe repeat nebs)
- Hyperglycaemia
- Paradoxical bronchospasm (rare)
Fetal & maternal notes
- • Safe every trimester
- • Compatible with breastfeeding
Key interactions
Non-selective β-blockers
AvoidAntagonise — bronchospasm
Steroids / diuretics
CautionAdditive hypokalaemia
Clinical pearls
- 💡 Check K⁺ after ≥3 nebs
- 💡 Every acute asthma admission = MDT review + step-up ICS
Content last reviewed: REPLACE_ME (e.g. 2026-07)
Spotted something out of date? See our disclaimer or use Report an Error above.